Predictors of Health-Related Quality of Life in Asthmatic Children

Abstract

For children with asthma, their perceived health-related quality of life (HRQL) is viewed as a valid outcome measure with which to evaluate care and guide clinical interventions. Numerous clinical variables have been associated with HRQL, but few studies have addressed the role of family functioning in relationship to this outcome. The current study extends the findings of an earlier meta-analysis that indicated that family functioning and illness severity were significant predictors of health-related quality of life in children with asthma. Sixty children and 60 parents or guardians participated in this study of school-age asthmatic children who, over the preceding year, received regular care at a pediatric respiratory clinic for their asthma symptoms. Demographic information was obtained from the adults, who also completed standard measures assessing family stress, adaptation, and cohesion. The children were interviewed by the investigator and completed scales to assess HRQL. The major outcome of interest was the child’s HRQL. The child’s level of control over symptoms and the accumulation of family demands, particularly those related to loss, transition, and illness/family care, negatively affected the child’s quality of life. Multiple regression analysis further revealed that level of control and transitions within the family accounted for 23% of the variance of scores measuring HRQL. Family cohesion emerged as a potential mediating factor that may buffer the negative effects of family stress and the lack of control that an asthmatic child may experience in symptom management. An appreciation of the relationships between family stress, cohesion, and HRQL for children with asthma will directly inform clinical practice. Additional family-centered clinical research that fully incorporates HRQL into a theoretical model of health outcomes will continue to refine effective clinical interventions for asthmatic children.